Department of Infection Control, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
BMC Infect Dis. 2020 Mar 4;20(1):193. doi: 10.1186/s12879-020-4920-4.
Microbial infection is the main cause of increased morbidity and mortality in burn patients, especially infections caused by multiple drug-resistant organisms (MDRO). The purpose of this study was to explore major microbial trends in burn patients.
This retrospective study was conducted at burn wards and intensive care units, where burn patients were admitted following an event of dust explosion. Data were collected for a number of variables including severity of burns, demographic and clinical characteristics, laboratory data, and therapeutic devices.
A total of 1132 specimens were collected from 37 hospitalized burn patients with mean TBSA of 46.1%.The most commonly isolated species were Staphylococcus spp. (22.4%). The highest rate of antibiotic resistance was observed in carbapenem-resistant A. baumannii (14.6%), followed by methicillin-resistant S. aureus (11.3%). For each additional 10% TBSA, the isolation of MDRO increased 2.58-17.57 times (p < 0.05); for each additional 10% of the third-degree burn severity, the risk of MDRO significantly decreased by 47% (95% CI, 0.38-0.73, p < 0.001) by Cox model.
The proportion of overall microbial isolates increased with the increase in TBSA and duration of time after burns. The extent of TBSA was the most important factor affecting MDRO.
微生物感染是烧伤患者发病率和死亡率增加的主要原因，尤其是由多重耐药菌（MDRO）引起的感染。本研究旨在探讨烧伤患者的主要微生物趋势。
本回顾性研究在烧伤病房和重症监护病房进行，这些病房收治了因粉尘爆炸而受伤的烧伤患者。收集了多项变量的数据，包括烧伤严重程度、人口统计学和临床特征、实验室数据和治疗设备。
从 37 名住院烧伤患者中采集了 1132 个标本，平均 TBSA 为 46.1%。最常分离的物种是金黄色葡萄球菌（22.4%）。耐碳青霉烯类鲍曼不动杆菌（14.6%）的抗生素耐药率最高，其次是耐甲氧西林金黄色葡萄球菌（11.3%）。TBSA 每增加 10%，MDRO 的分离率增加 2.58-17.57 倍（p<0.05）；三度烧伤严重程度每增加 10%，MDRO 的风险显著降低 47%（95%CI，0.38-0.73，p<0.001），这是通过 Cox 模型得出的。
总的微生物分离株比例随着 TBSA 的增加和烧伤后时间的延长而增加。TBSA 程度是影响 MDRO 的最重要因素。
